Breast cancer is the second leading cause of death among women in the world. According to statistics of the World Health Organization, in 2020 there were 2.26 million cases of this disease, while 685 thousand people died.

WHO’s target is to reduce global breast cancer mortality by 2.5 percent annually, which would save over 2.5 million lives from 2020 to 2040. This target is intended to be achieved through awareness for early detection, time of diagnosis and better management of this disease.

However, for many developing countries such as Kosovo, achieving this objective is problematic, at least in the situation in which we find ourselves. The best management of this disease and the reduction of mortality depends on how many factors and links of the health system, which not only in this case, but in most cases do not work properly.

In our country, according to the Statistics Agency, in recent years there has been an increase in the number of citizens affected by breast cancer. In 2019, there were 505 cases, in 2020 the number was slightly smaller, but it is believed that this decrease occurred due to the lack of diagnosis during the pandemic, whereas in 2021, the number increased again to 571.

Unfortunately, as with other diseases in Kosovo, we do not have accurate data on survival and mortality. We also do not have a national screening program that would enable systematic and early diagnosis of this disease to increase the chances of survival. In Kosovo, diagnosis depends mostly on awareness campaigns, but also on women’s awareness of this disease.

Fortunately, in Kosovo, there are opportunities to perform an imaging examination of the breast in most public health institutions of secondary and tertiary level, but also in family medicine centers in the municipalities.

In Kosovo, we do not have a Health Information System that would enable us to have accurate data on the number of citizens diagnosed with the disease and on their progress. Also, within this system, a national screening program could be made that would enable the early diagnosis of breast cancer and increase the chances of reducing mortality.

But, in addition to the problems of lack of information, data and screening, patients in Kosovo also face many problems during the treatment of this disease. Patients are often not properly instructed and do not have a clear idea of what the steps will be for their treatment and lack accurate information about the treatments, therapies or diagnostic procedures they must perform.

This happens due to two factors, poor management and lack of human and infrastructural capacities. There is only one Institute of Oncology within the University Clinical Center of Kosovo, which is a reference center for all patients treated with therapy against malignant diseases. The large flow of patients seeking help and treatment in this clinic is large, and the insufficient numbers of medical staff prevent better, and better quality management for patients.

In addition, patients often face a shortage of drugs and therapies for their treatment. Poor planning and lack of sufficient budget for anti-cancer drugs are two of the factors that influence this situation. Only in 2022, patients are faced several times with weeks of drug shortages, causing the postponement of receiving their therapies. In these circumstances, the progress of the patients’ treatment is jeopardized, but they are also financially damaged because their therapies have a very high cost.

Kosovo is almost the only country in the region that has only one referral center for therapeutic treatment of cancer patients. Thus, the University Clinical Hospital Service would have to increase the capacities in regional hospitals to enable citizens to receive therapies in these institutions.

Until we have a functional Health Information System and screening program institutions, and society should engage more in informing and raising awareness about the risk of breast cancer, especially among women, who are more vulnerable to this disease.

The Ministry of Health and the University Clinical Hospital Service must ensure patients that there is no delay in the supply of therapy. This security would not only facilitate the treatment but also the mental health of the patients who are already burdened by the disease.

This editorial was written within the Tuesday Salon with the topic: “Where has society stagnated in awareness of breast cancer, and how informed are they after diagnosis”?